Legislation to allow dying people to end their lives with lethal, physician-supplied drugs was approved by the state Senate on Friday and sent to Gov. Brown.

The action represented a remarkable journey for the controversial legislation, which was inspired in part by the death of a young California woman who had moved to Oregon, which has a physician-assisted death law. The measure was derailed earlier in the year when it was abruptly pulled from consideration just hours before a key Capitol hearing.

Brown, a Democrat, a Catholic and a former Jesuit seminarian, has 12 days to sign, veto or allow the bill to become law without a signature.

Backers included AIDS care groups, the American Nurses Association of California and the California Primary Care Association. The original version of the bill was SB 128 by Sen. Lois Wolk, D-Davis.

A 2005 Field Poll showed that more than two-thirds of Californians surveyed the notion that “incurably ill patents have the right to ask for and get life-ending medication.

Oregon’s death-with-dignity law was approved by voters there in 1997. Washington and Vermont have similar laws, and court decisions in Montana and New Mexico have “effectively authorized doctors to engage in the practice.” A 2005 Field Poll showed that more than two-thirds of Californians surveyed the notion that “incurably ill patents have the right to ask for and get life-ending medication,” and a similar number “would personally want to have this option if they themselves were terminally ill.”

Among the most vigorous opponents of the bill — ABx215 by Assemblywoman Susan Talamantes Eggman, D-Stockton — are the California Catholic Conference and the Alliance of Catholic Health Care, and a number of independent living centers cancer doctor associations. The oncologists – cancer doctors – opposed the bill because they claim erroneously that "it is contrary to a physician’s oath and primary responsibility to do no harm.”

Strong opposition to the bill from Catholic church, which considers suicide a mortal sin, and other groups, including the Archdiocese of Los Angeles. Other foes included the National Right to Life Committee, the Medical Oncology Association and groups representing independent living centers for aged adults. Some Latinos in the Legislature, many of whom are Catholics, expressed reservations about the legislation.

The California Medical Association earlier withdrew its opposition to the legislation.

Is physician aid-in-dying (PAD) ethically permissible?

The ethics of physician aid-in-dying continue to be debated. Some argue that PAD is ethically permissible (see arguments in favor). Often this position is argued on the grounds that PAD may be a rational choice for a dying person who is choosing to escape unbearable suffering at the end of life. Furthermore, the physician's duty to alleviate suffering may, at times, justify providing aid-in-dying. These arguments rely on respect for individual autonomy, recognizing the right of competent people to choose the timing and manner of death in the face of a terminal illness.

What are the arguments in favor of physician aid-in-dying (PAD)?

Those who argue that PAD is ethically justifiable offer the following arguments:

1. Respect for autonomy: Decisions about time and circumstances of death are personal. Competent people should have right to choose the timing and manner of death.
2. Justice: Justice requires that we "treat like cases alike." Competent, terminally ill patients have the legal right to refuse treatment that will prolong their deaths. For patients who are suffering but who are not dependent on life support, such as respirators or dialysis, refusing treatment will not suffice to hasten death. Thus, to treat these patients equitably, we should allow assisted death as it is their only option to hasten death.
3. Compassion: Suffering means more than pain; there are other physical, existential, social and psychological burdens such as the loss of independence, loss of sense of self, and functional capacities that some patients feel jeopardize their dignity. It is not always possible to relieve suffering. Thus PAD may be a compassionate response to unremitting suffering.
4. Individual liberty vs. state interest: Though society has strong interest in preserving life, that interest lessens when a person is terminally ill and has strong desire to end life. A complete prohibition against PAD excessively limits personal liberty. Therefore PAD should be allowed in certain cases.
5. Honesty & transparency: Some acknowledge that assisted death already occurs, albeit in secret. The fact that PAD is illegal in most states prevents open discussion between patients and physicians and in public discourse. Legalization of PAD would promote open discussion and may promote better end-of-life care as patients and physicians could more directly address concerns and options.